Before the introduction of highly active antiretroviral therapy (HAART), the majority of HIV-infected patients experienced diarrhea.
Dr Uzma Siddiqui and colleagues conducted a study to not only compare the prevalence of diarrhea among HIV-infected and uninfected patients in the HAART era, but also to evaluate the impact of diarrhea on health-related quality of life.
Diarrheal symptoms experienced by 163 consecutive HIV-infected patients and 253 HIV-seronegative control subjects were ascertained using a validated questionnaire.
|Diarrhea is still significantly more common in HIV-infected patients |
|Journal of Clinical Gastroenterology |
The health-related quality of life of these patients was assessed using the Medical Outcomes Study (MOS) SF-36 and MOS-HIV Health surveys.
Among the 163 HIV-infected patients, the median CD4 cell count was 370 cells/mm³ and, out of the 163 patients, 150 individuals were taking HAART.
Significantly more HIV-infected subjects reported having 3 or more bowel movements daily within the past 7 days than HIV-seronegative subjects did (28.2% vs. 7.1%, P<0.001), even after adjusting for potential confounding variables (odds ratios=6.65; 95% confidence intervals, 3.36-13.17).
In addition, diarrhea was significantly more common in HIV-infected patients than in control subjects when assessed by several other criteria.
HIV-infected patients reported notably worse health-related quality of lives across all domains of the MOS SF-36, as compared with control subjects.
Among HIV-infected patients, those individuals with diarrhea had significantly worse health-related quality of lives in nearly all domains of the MOS-HIV, when compared with those without diarrhea.
Dr Siddiqui concluded that, "Diarrhea still remains an important clinical problem in HIV-infected patients, and is associated with significant impairment in health-related quality of life".
It is important that healthcare providers specifically evaluate their HIV-infected patients for diarrhea, so that this symptom may be managed optimally .